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Over the last decade, anatomic total shoulder arthroplasty (aTSA) has undergone significant design and manufacturing changes that have led to progressive shortening of the humeral stem and even fully canal-sparing implants. Within the literature, minimal differences have been observed between stemmed and stemless aTSA with respect of overall clinical outcomes, complication rates, and survivorship over time. However, the utilization of stemless aTSA continues to rapidly increase with the proposed benefits of bone stock preservation, decreased operating time, decreased blood loss, and a decreased risk of humeral based intraoperative complications.
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Marigi et al. (2025) studied this question.
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